BACKGROUND: Ischemic colitis is a potentially life-threatening condition that can require colectomy for management. OBJECTIVE: To assess independent predictors of mortality following colectomy for ischemic colitis using a nationally representative sample of hospitals in the United States. METHODS: The Nationwide Inpatient Sample was used to identify all patients with a primary diagnosis of acute vascular insufficiency of the colon (International Classification of Diseases, Ninth Revision codes 557.0 and 557.9) who underwent a colectomy between 1993 and 2008. Incidence and mortality are described; multivariate logistic regression analysis was performed to determine predictors of mortality. RESULTS: The incidence of colectomy for ischemic colitis was 1.43 cases (95% CI 1.40 cases to 1.47 cases) per 100,000. The incidence of colectomy for ischemic colitis increased by 3.1% per year (95% CI 2.3% to 3.9%) from 1993 to 2003, and stabilized thereafter. The postoperative mortality rate was 21.0% (95% CI 20.2% to 21.8%). After 1997, the mortality rate significantly decreased at an estimated annual rate of 4.5% (95% CI -6.3% to -2.7%). Mortality was associated with older age, 65 to 84 years (OR 5.45 [95% CI 2.91 to 10.22]) versus 18 to 34 years; health insurance, Medicaid (OR 1.69 [95% CI 1.29 to 2.21]) and Medicare (OR 1.33 [95% CI 1.12 to 1.58]) versus private health insurance; and comorbidities such as liver disease (OR 3.54 [95% CI 2.79 to 4.50]). Patients who underwent colonoscopy or sigmoidoscopy (OR 0.78 [95% CI 0.65 to 0.93]) had lower mortality. CONCLUSIONS: Colectomy for ischemic colitis was associated with considerable mortality. The explanation for the stable incidence and decreasing mortality rates observed in the latter part of the present study should be explored in future studies.
BACKGROUND:Ischemic colitis is a potentially life-threatening condition that can require colectomy for management. OBJECTIVE: To assess independent predictors of mortality following colectomy for ischemic colitis using a nationally representative sample of hospitals in the United States. METHODS: The Nationwide Inpatient Sample was used to identify all patients with a primary diagnosis of acute vascular insufficiency of the colon (International Classification of Diseases, Ninth Revision codes 557.0 and 557.9) who underwent a colectomy between 1993 and 2008. Incidence and mortality are described; multivariate logistic regression analysis was performed to determine predictors of mortality. RESULTS: The incidence of colectomy for ischemic colitis was 1.43 cases (95% CI 1.40 cases to 1.47 cases) per 100,000. The incidence of colectomy for ischemic colitis increased by 3.1% per year (95% CI 2.3% to 3.9%) from 1993 to 2003, and stabilized thereafter. The postoperative mortality rate was 21.0% (95% CI 20.2% to 21.8%). After 1997, the mortality rate significantly decreased at an estimated annual rate of 4.5% (95% CI -6.3% to -2.7%). Mortality was associated with older age, 65 to 84 years (OR 5.45 [95% CI 2.91 to 10.22]) versus 18 to 34 years; health insurance, Medicaid (OR 1.69 [95% CI 1.29 to 2.21]) and Medicare (OR 1.33 [95% CI 1.12 to 1.58]) versus private health insurance; and comorbidities such as liver disease (OR 3.54 [95% CI 2.79 to 4.50]). Patients who underwent colonoscopy or sigmoidoscopy (OR 0.78 [95% CI 0.65 to 0.93]) had lower mortality. CONCLUSIONS: Colectomy for ischemic colitis was associated with considerable mortality. The explanation for the stable incidence and decreasing mortality rates observed in the latter part of the present study should be explored in future studies.
Authors: C Flobert; C Cellier; A Berger; A Ngo; E Cuillerier; B Landi; P Marteau; P H Cugnenc; J P Barbier Journal: Am J Gastroenterol Date: 2000-01 Impact factor: 10.864
Authors: Gilaad G Kaplan; James Hubbard; Remo Panaccione; Abdel Aziz M Shaheen; Hude Quan; Geoffrey C Nguyen; Elijah Dixon; Subrata Ghosh; Robert P Myers Journal: Arch Surg Date: 2011-08
Authors: Miguel A Montoro; Lawrence J Brandt; Santos Santolaria; Fernando Gomollon; Belén Sánchez Puértolas; Jesús Vera; Luis Bujanda; Angel Cosme; José Luis Cabriada; Margarita Durán; Laura Mata; Ana Santamaría; Gloria Ceña; Jose Manuel Blas; Julio Ponce; Marta Ponce; Luis Rodrigo; Jacobo Ortiz; Carmen Muñoz; Gloria Arozena; Daniel Ginard; Antonio López-Serrano; Manuel Castro; Miquel Sans; Rafael Campo; Alex Casalots; Víctor Orive; Alberto Loizate; Lluçia Titó; Eva Portabella; Pedro Otazua; M Calvo; Maria Teresa Botella; Concepción Thomson; Jose Luis Mundi; Enrique Quintero; David Nicolás; Fernando Borda; Benito Martinez; Javier P Gisbert; María Chaparro; Alfredo Jimenez Bernadó; Federico Gómez-Camacho; Antonio Cerezo; Enrique Casal Nuñez Journal: Scand J Gastroenterol Date: 2010-10-20 Impact factor: 2.423
Authors: J Alexander Cole; Suzanne F Cook; Bruce E Sands; Anuli N Ajene; David P Miller; Alexander M Walker Journal: Am J Gastroenterol Date: 2004-03 Impact factor: 10.864
Authors: Alexander M Walker; Rhonda L Bohn; Clorinda Cali; Suzanne F Cook; Anuli N Ajene; Bruce E Sands Journal: Am J Gastroenterol Date: 2004-07 Impact factor: 10.864